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Smallpox vaccine costs raise questions

By Julie Appleby, USA TODAY

The smallpox vaccination effort could raise costs for hospitals, health insurers and employers, a concern likely to pit them against the government over who will pay for vaccine-related medical care and lost work time.

		This vial holds about 100 doses of the smallpox vaccine.
		By Scott A. Miller, Getty Images

The American Association of Health Plans, for example, is seeking assurance from the Bush administration that the government, not private insurers and employers, would pay for vaccine-related health costs.

Side effects range from mild fevers to life-threatening brain inflammations. One to two out of every million vaccinated is expected to die.

"We can't imagine that the government would have the expectation that the cost of a national homeland security program should be borne by employers and their employees," says association President Karen Ignagni. The health care industry's concerns include:

• Will workers' compensation cover lost work time for medical and emergency workers who volunteer to receive the vaccine? Those costs could increase worker compensation costs.
• Will the government set up an injury compensation fund, similar to one in place for injuries from childhood vaccines? Consumer advocates and labor unions say the smallpox program provides little chance that patients who sue the government for vaccine-related injuries would be compensated.

Secretary of Health and Human Services Tommy Thompson, in a press briefing Saturday, said most states are expected to pay workers' compensation for lost work time for medical or emergency personnel sickened by the vaccine. Modest death benefits are also available. Unions, however, say those amounts are likely to be inadequate.

Thompson also said that health care workers — and private citizens who seek the vaccine — would need their own health insurance to pay for any care needed to treat side effects.

"The next question you're going to ask me is, 'Is that fair?' because hospitals' workers' compensation rates might go up ... or the health insurance premiums might go up," Thompson said. "The truth of the matter is that we have not done anything in that regard yet."

Just as states were given federal money for emergency vaccination plans, Thompson said there might be funds for "any further costs that may result as a result of this vaccination program." A compensation fund for victims is not yet being discussed, he said. Unions, health insurers and hospitals say they want such a fund.

"Let's say we have a young woman who works as a nurse and she ... dies from the vaccine. Shouldn't we do something like we did for the victims of 9/11, provide the family with some compensation?" says James Bentley of the American Hospital Association.